Recurrent renal hyperparathyroidism and DNA analysis of autografted parathyroid tissue

Publisher Website
Google Scholar
Abstract
In spite of recent therapeutic advances, severe overt secondary hyperparathyroidism due to chronic renal failure necessitates parathyroidectomy and recurrent hyperparathyroidism is one of the most significant problems in this patient population. In the present study, the incidence of recurrent hyperparathyroidism was evaluated in relation to the histopathological features. Image cytometric DNA analysis was performed to estimate the proliferative potential of parathyroid tissue. The study comprised 248 patients who underwent parathyroidectomy from 1973 to 1991. The frequency of recurrent hyperparathyroidism after subtotal parathyroidectomy was 4 (21.1%) of 19 patients, the rate of graft-dependent recurrence after removal of residual parathyroid tissue with forearm autograft was 2 (50%) of 4 patients. The frequency of graft-dependent recurrence after total parathyroidectomy with forearm autograft was 16 (7.5%) of 212 patients. The frequency of recurrence was significantly higher (ppppp<0.01) cuando se autotrasplantó tejido hiperplásico nodular (17/68; 25%) que cuando se autotrasplantó tejido hiperplásico difuso (1/105; <1%). La totalidad de los 58 especímenes sometidos a análisis de DNA por citometría de imagen exhibió un patrón nuclear diploide. Sin embargo, el número de células dispersas que exhibieron valores citométricos de DNA nuclear por fuera del pico...